Recently I went to Shillong to see a friend and I met a very interesting woman there. Sonali Shinde Tesia is one of the leading psychiatrists in Shillong, capital city of the northeastern state of India, Meghalaya. The state is the fashion and cultural capital of the Indian northeast given that it is the most peaceful state in the region at present. What followed was a really interesting conversation on mental health issues in Shillong.

Tesia mostly deals with middle class and upper middle class clientele and runs a clinic with her husband Pakha Tesia, who deals more with addiction cases. Over the course of the conversation we delved into the effect of rapid liberalization in Shillong and the historical effect of British colonial rule on the mental health of locals, even now.

Tesia, based on her clientele and experience (about 16 years), found that due to newly acquired money and no guidance on how to spend it, family bonds for many locals have become really shallow. The traditional family structure in which people would give each other support has been replaced by money. That, in effect, has had a tremendous effect on the younger generation in the area, who feel they can’t bond with their families, but refuse to grow up and take on the responsibilities of life. There is a pathological dependence problem in many cases she has encountered.

Due to rapid change and the influx of money and gaudy shops, there has been pressure put on relationships between younger generations striving to acquire the markers of modernity and their parents, in many cases a tribal generation accustomed to a simpler life. The problem persists even with academics: They cannot help their children with much constructive guidance about what to do in life. The concept of a caregiving generation has been completely ruined by the capitalistic onslaught. This is creating an emotional rift between the generations. Younger Meghalaya citizens feel like no one understands them.

The case is quite similar with that of the Jantia tribe people, who belong to a different region of Meghalaya. Suddenly they found coal in the region and everyone was suddenly too rich for their own good – or understanding. They all wanted to move to Shillong, since it is the most exciting place in the region. These new moneyed people have also developed rifts with the locally dominant Khasi tribe people – to the point where there is clear discrimination or non-interaction. All this has taken a heavy toll on the younger generations and caused general animosity.

The other difficulty Tesia has found is in dealing with people who are stuck in between different identities and basically end up being confused and conflicted. Indians could never have the influence on the northeastern people like the British did because they came along with religion. The Christian missionaries changed many value systems of the indigenous people. In time, this has had risen to conflict within people in terms of personal value systems. Christianity comes with its own set of rigid rules and conventions. It is still a confusing state for people who follow Christianity, but also want to follow their ancient traditions as it is a part of their identity. A young 20-year-old boy I met recently said “my Church says that we shouldn’t follow anything else, but I follow my Church and my Khasi tradition both. Because if I don’t follow that, then who am I, what is my identity, where do I stand in this world?”

Juggling between older tribal traditions and modern Christian values, there are complex problems that have come up. The society is more or less free and young girls around 15 or 16 years of age getting pregnant is not unheard of, according to the doctor. She says that it is not even looked down upon. Life basically just keeps going on – unless it cannot.

Drug and alcohol misuse is quite obvious in the above mentioned circumstances, but that is another issue to be explored altogether.

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In terms of seeking help, Tesia feels that indigenous people may initially feel hesitant but once they start the treatment, they usually stick with it. Some people who find it too shameful to get treated locally also go to Guwahati, capital of the neighbouring state of Assam. There is a floating population of clients between Shillong and Guwahati – many people come to Shillong to get treated so that locals don’t find out there.

There are about 15 private psychiatrists working in Shillong, along with the Sunrise hospital meant especially for mental health issues. Tesia doesn’t clearly know how many people might be suffering or are getting treated, but she daily receives about 30 to 40 patients at the OPD (Outpatient Department) in her clinic which she shares with her husband. All of this does not paint the picture of a good mental health for this buzzing city.

Parul Abrol is Roving Correspondent for Firstpost, mostly writing on the Northeast India.